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  本文選題：映射法　切入點：健康效用值　出處：《中國藥房》2017年29期 　論文類型：期刊論文

【摘要】：目的:為將非效用量表測量結(jié)果轉(zhuǎn)化為健康效用值提供方法學(xué)參考。方法:查閱國內(nèi)外文獻,總結(jié)健康效用值測量中的映射法及其相關(guān)模型,并以生存質(zhì)量量表測量結(jié)果轉(zhuǎn)換成歐洲五維健康量表效用值為例,介紹各模型在概率映射中的應(yīng)用。結(jié)果:映射法可通過建立非效用量表和效用量表之間的映射關(guān)系,進而得到健康效用值;其常用模型包括普通最小二乘法(OLS)模型、最小絕對離差法(CLAD)模型、Tobit模型、多元Logistic回歸(MNL)模型、貝葉斯網(wǎng)絡(luò)(BN)模型等。其中,OLS模型相對簡單,預(yù)測效度較好,但會受到天花板效應(yīng)的限制;Tobit模型不受天花板或地板效應(yīng)的限制,當(dāng)誤差項滿足方差齊性及正態(tài)性時,其預(yù)測結(jié)果優(yōu)于OLS模型;CLAD模型可用于誤差項非方差齊性不適用Tobit模型的情況;MNL模型先通過回歸分析確定一種健康狀態(tài),再確定其效用值;BN模型預(yù)測效度較好,且不涉及計量經(jīng)濟學(xué)中的諸多假設(shè)和限制條件,但其構(gòu)建過程受領(lǐng)域?qū)＜业挠绊戄^大。使用MNL或BN模式計算健康效用值的方法主要有蒙特卡洛模擬法、期望效用值法和最大可能概率法等。利用擬合優(yōu)度、調(diào)整擬合優(yōu)度、平均誤差、均方誤差、平均絕對誤差等指標(biāo)進行模型性能評價,可選出最優(yōu)模型,進而計算健康效用值。結(jié)論:由于各映射模型各有優(yōu)缺點,在臨床研究中需要根據(jù)實際情況選擇不同的映射模型。
[Abstract]:Objective: to provide a methodological reference for converting the non-utility measurement results into health utility values. Methods: the mapping method and its related models in the measurement of health utility values were summarized by consulting the literature at home and abroad. The application of each model in probabilistic mapping is introduced by taking the result of quality of life scale as an example. Results: mapping method can establish the mapping relationship between non-utility scale and utility scale. Then the health utility value is obtained. The commonly used models include the ordinary least square method (OLS) model, the minimum absolute deviation method (CLAD) model and the Tobit model, the multivariate Logistic regression model and the Bayesian network model, among which the OLS model is relatively simple. The prediction validity is good, but limited by the ceiling effect. The Tobit model is not restricted by the ceiling or floor effect. When the error term satisfies the homogeneity and normality of variance, The result of prediction is better than that of OLS model. The model can be used to determine a health state by regression analysis, and then to determine the validity of OLS model when the non-variance homogeneity of error term is not applicable to Tobit model. Moreover, it does not involve many assumptions and restrictions in econometrics, but its construction process is greatly influenced by domain experts. Monte Carlo simulation is the main method to calculate health utility value using MNL or BN model. The method of expected utility value and the method of maximum probability are used to evaluate the performance of the model, and the optimal model can be selected by using the indexes of goodness of fit, adjustment of goodness of fit, mean error, mean square error, mean absolute error, etc. Conclusion: because each mapping model has its own advantages and disadvantages, it is necessary to select different mapping models according to the actual situation in clinical research.
【作者單位】： 中國藥科大學(xué)國際醫(yī)藥商學(xué)院;
【分類號】：R95

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本文編號：1558727